PCOS and Weight Loss (PCOS&WL) Series III – 10 tips to curb food craving

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food craving I am writing this post with a great sense of satisfaction because this is one area which I have managed to be good at after PCOS. It is wonderful indeed to say that I no longer crave food – especially the junk food types. How much restrain was needed during the initial days!! And the resulting longing and craving and sometimes the depression (Why only me? type) were difficult to handle too. But do you know that a food craving can only last for few minutes – maximum up to 10-15 minutes. Once you overpower the craving, the sense of self satisfaction is immense and am sure will be a motivating factor for future self restraints.

It hurts more to drink coffee or smoke a cigarette to curb the craving. Coffee does two bad things at once for PCOS – caffeine and diary. I need not even talk about cigarettes. I know that it is easier said than done to stop the food craving especially when the whole wide world is filled with the beautiful aroma of food. But, its not just good for our PCOS but also for our general health that we stop these cravings. It might be difficult in the beginning, but you are going to gain a lot in the long run and lose a lot too – i meant the weight :)

food craving 1 Ok here goes my tips from my personal experience – believe me these do work. Tips 1-5 are for the initial stages. Once you have started practicing the restraints, you feel it’s time to give up on the cranberry juice and the occasional carrots between meals, 6-10 will help.

 

 

 

  1. Water: When you have that ‘must have food now’ moment, get a glass of water and gulp it down. Drinking lot of water detoxifies the body and stops that food craving too.
  2. Take alternative snacks. Don’t imagine I’m going to say Kellogg’s K snack. I meant carrots, almonds, pistachios or raisins. These can be very useful during the initial days of self control. Almonds and Pistachios are rich source of Vitamin E, Omega 3 fatty acids and are very good and recommended for PCOS.
  3. Eat regular paced out meals. Most importantly Do Not Skip Meals. Skipping meals and untimely meals make you crave more for junk food. Have your own regular meal time
  4. Cranberry Juice – this was a life saver during my initial days of fight against food cravings. Cranberry juice in general is good for female genital health and cures UTI.
  5. Take a power nap. This helps because as I said, the craving stays only for few minutes. Power nap also freshens one up. Or even better take a walk! Just distract yourself doing something else.
  6. When next time the craving starts, hold it for a minute there. Question this to yourself “Am I really hungry or do I just want it for the taste?” Reasoning with myself is by far the best method that has worked for me
  7. Reduce the quantity of sugar and salt in the meals because these are known causes for food craving. Reducing white sugar intake helps in weight loss
  8. Have interesting meal recipes. This helps me in having a satisfying meal and avoids mid meal cravings.
  9. Rinse the mouth or Brush the teeth. This is a sure shot method to stop food craving. This also helps improve the oral hygiene. More better wash the face – tackles that acne too!
  10. Next time you crave for food, don’t think about buying food, think about making it yourself. Sometimes I lose the interest in the food when I’ve to make it myself :P But if you can still persuade yourself, give in, make it, and savor it too. Then there is nothing better that works like the guilt. Trust me you will stop your cravings at least for one week after that.

Well these worked for me and I hope they work for you too in controlling the mid meal food cravings. Expect to see more on eating right in future posts!

Have success stories in stopping your food cravings, please do share them here!

PCOS and Weight Loss Series II

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“Those who think they have no time for healthy eating, will sooner or later have to find time for illness.” - Edward Stanley

Today’s tip is about the drink that has substituted water among the younger generation.Yup, am talking about the COCA-COLA. Did you think ‘Pop open Good Times’ or ‘Open Happiness’ was for you?? Naah, thats just for the company. All that you get is unwanted calories and more weight!

When coca cola was originally created, its major ingredients were Cocaine and caffeine and hence the name Coke. Cocaine was later removed but caffeine is still added which makes us get addicted to Coke without realizing it. Whats more tempting? – The Price. Have you ever noticed that Coke costs less than water!

What happens when I drink Coca Cola?

Here are some interesting facts on what happens when you consume a can of coke:

image

And what happens when I feel dehydrated? Thats right, Pop open another Coke! The design is by itself compelling us to consume more of what we must avoid like hell. Did you notice the Blood sugar and Insulin spike in 10-20 mins? Well for someone who is blessed enough to be normal, this can be alright. But with an already high level of free insulin (because of the insulin resistance), the extra insulin is definitely not what we want.

This is not just limited to Coke. The same holds good for all the other aerated drinks. In fact Fanta and other more sweeter versions have even more sugar content than in Coke.

Coca cola and Fertility

This might sound ridiculous, but the fact is that Coca cola douches were used for contraception in the 50’s and 60’s when the now effective methods were unavailable. Coca cola when mixed with human sperm (5:1 ratio) immobilizes the sperm instantly. High sugar content of Coca-Cola risks vaginal yeast and bacterial infections. In general, carbonated beverages have detrimental effects on lactobacilli, beneficial bacteria present in a healthy vagina (they maintain the normal vaginal ecosystem).

Not just that, it is a major cause of obesity which directly affects the fertility as outlined in my previous post on obesity and fertility.

The horror doesn’t end there. Do you know that Coca cola or any aerated drink for that matter increases the level of carbon-di-oxide in the blood. In a college competition at Delhi University on who drinks most coke, a student died on consuming 8 bottles of coke because of the high Carbon di oxide level. It has been clinically proven that one of the major reason for Cancer is low oxygen content in the cells of body.

I have reduced a good deal of weight by staying away from Coke and mid meal snacks. There are many more PCOS-ers who have brought their weight down just by cutting Coke off their regular diet. The testimonies are in many PCOS forums.

Alarming alternate uses of coke/Pepsi

  1. Coke removes stain off the toilets with no scrubbing. The citric acid in coke does the magic
  2. Apply a cloth soaked in coke to a rusted bolt for an hour or so, it comes off like a piece of cake
  3. Add the contents of a coke can along with detergent to your laundry load, greasy stains will disappear from the clothes
  4. Are the car battery terminals corroded? Try pouring bit of coke there and see the corrosion bubbling away

Are you still ready to drink this excellent multi-purpose cleaner? Shall we take the first step today and say no to Coke/Pepsi?

PCOS and Weight Loss Series I

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We had discussed in length about PCOS, Obesity and Fertility in one of the earlier posts. It is essential to understand that weight loss plays a major role in controlling the PCOS symptoms, controlling the insulin resistance in the body and most importantly in improving the fertility.How nice would it be to have a regular cycle! So the first step that we can take to help ourselves is to bring down that extra pounds.

But thats where the problem starts, cutting the weight is easier said than done. So I am planning to write a series of tips, PCOS friendly recipes, exercise, yoga and diet changes that can help you in this Himalayan task.

Body Mass Index (BMI)

BMI and weight loss As this is the first post in the series, I wanted to tell you about the ideal weight that one must maintain not just for PCOS but also for a healthy living. No prizes for guessing, I am talking about BMI (Body Mass Index)

Lets start by defining BMI. According to Wikipedia,

 

“The body mass index (BMI), or Quetelet index, is a heuristic measure of body weight based on a person's weight and height. Though it does not actually measure the percentage of body fat, it is used to estimate a healthy body weight based on a person's height”

\mathrm{BMI} = \frac{\mbox{mass} \ \mbox{(kg)}}{\left( \mbox{height}(\mathrm{m})\right)^2}

The BMI chart varies between the genders and I am going to focus just on the female BMI chart. Here is how the BMI values are interpreted:

  • BMI = <18.5           Underweight (value<16 is considered severely underweight)
  • BMI = 18.5–24.9       Normal weight
  • BMI = 25–29.9         Overweight
  • BMI >= 30             Obese (these are further divided into Class I(<35), II(35-39.9),III (>40)

These BMI values also varies by the region of origin (For example Asian – typically Japanese and Singapore have a lesser value ranges. For them a value > 23 is overweight).

Why is understanding BMI important?

If you had visited one of those rare to find good and patient Doctors, their first advice to you would be to lose weight (or gain in really very very rare cases) before starting with any kind of fertility medication. This is because a greater BMI is indicative of fat-related extra weight and according to Dr. David Hoffman of IVF Florida Reproductive Associates, “Fat makes hormones and these additional estrogens can then interfere with optimal hormone levels."

Sad enough that the hormones are already dancing to their own tunes, obesity adds to the misery. Most of the PCOS women have shown to be with BMI>30. This not just aggravates the symptoms but also hinders fertility and increases risk of miscarriage.

Important point to note:

BMI cannot differentiate between muscle mass and fat mass. So if you are an athletic person (which is really good especially since you are already obsessed with staying in shape), a higher BMI does not always mean you have bad fat mass in the body.

Where do we start?

Lets start with finding out our BMI values. You can use the fun BMI calculator below which will give you the BMI value and which celebrity do you resemble to in terms of BMI.

 

Alternatively, you can also refer to this easy to interpret BMI Chart to know about the target weight ranges.

The pivotal point here is that yes, we definitely need to reduce the weight. But take that easy. Don’t go increasing your stressing with thoughts of reducing the weight and societal judgments. That is going to be counteractive, because in PCOS, stress and depression influence the hormones on a higher scale than what you’d imagine.

Always remember, a healthy mind makes a healthy body. So take it easy and start with the simple step of cutting the amount of your daily Soda dose. I am going to write more on that in my next post. Till then, happy losing!

I’d love to here more tips and your success with weight loss, do leave them in comments!

Hormone level ranges in menstrual cycle

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blood test tubes When I came to US and went to see a doctor for my condition (I even told here I was PCOS), the first thing she did was to order a lot of blood work. I am sure all fertility tests begin with the blood work. Just like everyone, I had no clue what these levels were. Even though there was a chart in the blood work that says the normal value ranges, I was still confused as my levels were either lower or elevated than normal. I couldn’t comprehend what the higher/lower levels meant.

This can be really frustrating because in most cases, doctors also do not really say much about what the lower/higher levels mean. So I started reading on the net and found some answers though not all. In this post, I want to share the details of the normal ranges and what a deviation from normal means.

Ok, there are several vials of blood taken from you on the Day 3 of your cycle. This stage is called the follicular phase and the levels are termed ‘Follicular Phase levels’. Later some more tests are done on Day 7 of your cycle, which is called the mid cycle phase and usually LH is checked at the surge period (Days 13 to 15) to check for ovulation.

These values are the average normal ranges and the ranges may differ from lab to lab. These values are presented just for the reference purposes so that you can better know about the hormone levels and ask your doctor precisely about the doubts that you may have. These values must not be used for self diagnosis or treatment.

Hormone Day Normal range What does a lower level mean? What does an elevated level mean?
FSH Day 3 3-20 mIU/ml This test is done to find out the ovarian reserve.
<6 – very good
6-9 – Good
9-10 – fair
10-13 – diminished reserve
>13 – very hard to stimulate
Estrodiol (E2) Day 3 25-75 pg/ml Lower levels are better for stimulation Very high values may indicate a low ovarian reserve or that a cyst is already present
LH Day 3 <7 mIU/ml   Higher value of LH (meaning a higher LH:FSH ratio) indicates PCOS condition
Prolactin Day 3 <24 ng/ml   Higher levels in this test are usually followed by a MRI to test for pituitary tumor. High value of prolactin discourages ovulation
Progesterone Day 3 <1.5 ng/ml Lower levels occur in PCOS. Several fertility supplements and progesterone patches are available to correct this Low pregnancy rate
Thyroid Stimulating Hormone (TSH) Day 3 0.4-4 uIU/ml   Indicative of hypothyroidism and this directly affects fertility
Free Triiodothyronine (T3) Day 3 1.4-4.4 pg/ml   A disease affected thyroid gland may produce high levels of T3. But the thyroid function cannot be defined just by this. T4 levels must also be considered.
Free Thyroxine (T4) Day 3 0.8-2 ng/dl A nonfunctional thyroid gland or a nonfunctional pituitary gland which has to stimulate the thyroid gland. A low T4 and normal TSH points to a pituitary problem  
Total Testosterone Day 3 6-86 ng/dl   Values greater than 50 are usually considered elevated levels
Free Testosterone Day 3 0.7-3.6 pg/ml   Higher values are another indication of PCOS
DHEAS Day 3 35-430 ug/dl   Elevated values are seen in PCOS condition. Insulin-sensiting medications are prescribed for correcting this.
Androstenedione Day 3 0.7-3.1 ng/ml    
Sex Hormone Binding Globulin (SHBG) Day 3 18-114 nmol/l Higher androgen levels are responsible for lower SHBG levels  
17 Hydroxy progesterone Day 3 20-100 ng/dl    
Estradiol (E2) Day 5 100+ pg/ml
or
2 times value of Day3
Lower values indicate anovulatory cycle  
Estradiol (E2) Surge Day 200+ pg/ml
(200-600 per a follicle of 18mm size)
Obesity can cause a lower value  
LH Surge Day
(usually 13 to 15)
>20 mIU/ml
(ovulation occurs in 36-48 hrs)
No surge indicates anovulatory cycle  
Progesterone 7 days post ovulation >15 ng/ml   >5 indicates ovulation
in normal cycle, it is expected to be >10 and in medicated cycles, the value is expected to be >15

 

There are several other tests that are taken when one goes for a fertility treatment. I am going to write about those tests and what they mean in my future posts.

I hope these info helps at least in a small way.

Have I missed any hormone values? Do you have more information on the hormone levels from your doctor? Please share them in the comments.

How do I know if I have PCOS?

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Now, the title of this post may have you wondering if this is going to be a replica post to the post about symptoms of PCOS. No, its not. In fact, one of my friend’s question is the main reason why this post is here. She chanced to go through my blog and started wondering if she had PCOS because in her words “3 of the symptoms do match”. To be honest I was taken aback and also thought how many women who are TTC (trying to conceive) might get a skewed perception by reading through the symptoms. So I thought, it would do more good to have a post on clarifying that point.

So here goes the list of points to consider before thinking that you might have PCOS too:

  1. Acne: Don’t go thinking  “Am I PCOS?” if you got a pimple because you have your periods around the corner or if you had an exciting evening and went to bed forgetting to take your make up off. Trust me, PCOS acne is far worse than that, there is no reason why that pimple would come and that too in groups (instead of that cute single pimple on the cheek) and most importantly never take the name of leaving your face whatever you do about it. Having a pimple or two is not an acne issue.
  2. Facial Hair: Most of the girls have small and very fine hair in the upper lip and lower lip regions and they are not visible and are definitely not an eye sore even if it is not removed. If you have PCOS, and if you are one of the unlucky few like me to have this symptom, the hair in these areas are not the fine cat hairs. They are dark and thick and the it is truly agonizing that it must be removed regularly to go out without embarrassment.
  3. Mood Swings: It is absolutely normal if you have mood swings just 2 days before the periods or sometimes during ovulation too (around the mid of your regular cycle). These are not the mood swings that I am talking about in the symptoms. Ask yourself if you ever felt depressed so much that you started crying for no reason at all?? Had you ever had the experience of being so happy in the morning and going to bed crying in the night? That's the mood swing I am talking about. In my case, sometime I get depressed for no reason at all and later stay sad the whole day getting only negative waves.
  4. Irregular Cycle: Some girls think their cycles are getting irregular when they miss an odd period or if they cycle started a week earlier (for ex: anxiety can cause an early period) once in a blue moon. FYI, those are not at all symptoms of PCOS! In PCOS condition, one would have lesser than 8 periods in an year with no/very less cramps and very little bleeding or have more than 15 periods in an year bleeding as if thats never going to stop ever.

You can find an excellent PCOS self test questionnaire here. If you have serious doubts, you could try filling this questionnaire up. But the best thing to do is to visit a doctor. Never come to conclusions on your own and don’t get medication ideas from your PCOS friends. A qualified doctor is the only person who can say if you do/don’t have PCOS and even if you conclude that you have PCOS from the self-test questionnaire, don’t do any self medication because the treatment for this may also differ based on your need (like TTC, not sexually active or sexually active but not planning to conceive) and based on your differing symptoms (few may not be insulin resistant as in the case of 70% of PCOS women and may not need diabetic drug).

PCOS, Obesity and Fertility

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For most of us with PCOS, one of the most frequently heard taunt is “Do something about your weight”. Yeah, even I have heard that. What I hate most about PCOS is that all its symptoms are physical – meaning they catch the eye and being overweight is one of them. Try whatever you might, the extra pounds don’t want to leave you at all.. So today is going to be a post on obesity.

How are PCOS and Obesity related?

Would you believe that even experts are confused on this part? They are still wondering “Which came first – Chicken or the Egg?” Yeah, nobody is still clear if obesity leads to PCOS or if PCOS causes obesity. But over 50% of the women with PCOS are Obese. It is also important to remember that the “PCOS Theorem”  applies here too that is, one can still have PCOS and not obese (like me).

PCOS Theorem: If you have PCOS, you can either have cysts in ovaries or not have them, you can either be overweight or be underweight, you may or may not have acne, you may have excess facial hair or body hair or both or in lucky cases none, you may have more than 12 periods in an year or none at all, your periods bleeding would be just one pad volume or you might receive award from the sanitary pad company for maximum usage, and you may or may not have fertility problems. In a nutshell, PCOS is a world of fuzzy uncertainties

What causes this Obesity in PCOS?

Insulin resistance is the culprit behind the Obesity. Almost 70% of PCOS women are insulin resistant which means the glucose metabolism does not happen how it should actually be. The level of blood sugar is high and pancreas keeps secreting more and more insulin to nullify this and as a result, the body stops responding to the insulin and glucose starts building up as fat. This is something serious because the effects does not stop with Obesity, it makes us more susceptible to diabetes at an younger age and in some cases gestational diabetes during pregnancy. Not just that, according to Samuel S. Thatcher, MD, PhD, F.A.C.O.G., USA, Director, The Center For Applied Reproductive Science, “obese individuals have greater risk of hypertension, high blood pressure, diabetes, cancer, stroke, gall bladder disease, and uterine cancer” (are there any more diseases in the world that he has missed to mention here???)

Does losing weight help?

Yes, it definitely does. Though it may be unclear if obesity does cause PCOS, but it is a proven fact that obesity exacerbates the PCOS condition and its symptoms. Studies have proven than reducing 10% of the body weight can be very effective in regulating the menstrual cycle and the ovulation. If you get lucky, reducing weight can eventually reduce the androgen levels and relieve you of some of the embarrassing symptom like acne and facial hair. Doctors agree that reducing weight makes infertility treatment to be more effective. So put that cake down and start gym-ing today!

Hormones and Periods

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Ok, we did talk a lot about hormones not in balance and periods not being regular. Someone who had studied biology in their higher secondary might comprehend this, but others are left without any clue. As such PCOS leaves us much confused, so I thought I’d write a post that is not actually a biology class but will throw some light on the hormones and their role in periods and what is wrong with us with PCOS.

I found these two images from internet which are by far the best depictions that I’ve seen. Thanks to the sites!!

hormone actions for normal cycles   normal menstrual cycle

The first pic shows how the hormones are responsible for having a regular cycle. It is interesting to note here that the Pituitary gland which is located near the brain is responsible for controlling all the hormones that make the ovaries function normally. Pituitary sends the LH and FSH (Luteinizing and Follicle stimulating Hormones) which determine the follicle formation and most important part Ovulation. After getting the signals from pituitary, the ovaries generate estrogen and progesterone. These are responsible for the uterus lining (endometrial thickness) and for menstruation when there is no fertilization of the egg.

The second pic shows the phases in the menstrual cycle and the normal hormone levels during each phase.

What happens to the hormones with PCOS?

In case of PCOS women, the LH is always higher than the normal levels. That means, even on the day one of the cycle, LH is higher than the FSH. As the LH levels are quite high, there is no LH surge meaning no ovulation. Thus the progesterone and estrogen (to be secreted by the follicle post ovulation – Corpus Luteum) levels also go out of balance and hence there is no periods for the cycle. The worst part in all this is that the follicle that failed to ovulate remains as the cyst and continues to produce more male hormone (androgen) causing all the unwanted hair and acne.

Another reason why the male hormone level goes up is the “Insulin Resistance” (this is going to be a separate post). Most of the PCOS women are insulin resistant which means, the level Insulin hormone secreted by Pancreas is high which causes the ovaries to make more testosterone.

I hope this post will be helpful in clarifying the hormones that your doc always keeps talking about at least to some extent. Do let me know if I have missed anything!